Licence: Public Domain Mark
Credit: The late epidemic of scarlet fever in St. Marylebone. Source: Wellcome Collection.
Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.
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![district, 39 in Christ Church di.strict, and 26 in St. John’s district. The largest number of deaths occurred in the third week in December, when 13 were registered, the smallest in the fourth week of January, when only 2 were registered. The jn-oportion of deaths to attacks can only be approximately estimated, for the reason that I have no satisfactory means of knowing the number of cases treated in private medical practice; but from the returns furnished to me weekly by the charitable institutions in the parish, I find that between the first week of September, 1869, and the last week of February, 1870, the number of new cases of Scarlet Fever which came und r treatment amounted to 583, and if one-third of this number be added as con- stituting the aggregate of the cases which occurred in priA'ate practice, we shall get a total of 777, which may be taken as a tolerably correct estimate of all the attacks from the disease in the parish during the six mouths that it prevailed as an epidemic. From these numbers it appears that the proportion of deaths to attacks was 23-7 per cent., or rather less than one in every four cases. The number of deaths in each district shew that the disease was fairly distributed over the entire parish, and that both as regards the number of deaths and persons attacked, they bore a very near relation to the population of such district. In the Rectory district it Avas the most fatal, and in St. John’s the least so. The number of deaths amongst children under 5 years of age was 123; between 5 and 20 years, 57 , and above 20 years, 4. Many deaths Avere registered as having occun-ed from Scarlatina maligna, and Scarlatina anginosa, and some few from Dropsy superA'ening. The disease Avas by no means e.si)ecially prevalent amongst the dirtiest and most de.stitute classes, it principally occurred amongst children of the res- pectiible ])Oor, and more frequently than otherwise in bouses where the Sanitary conditions Avcre by no means defective; but one feature in regard to the disease is very notcAvorthy—by far the largest number of attacks and deaths occurred in houses which Avere occupied by several families—and from this fact Ave may fairly conclude that in this parish at least, and jn-obably through- out the entire metropolis, it Avas propagated amongst tire inhabitants by con- tagion, and that an impm-e atmosphere, produced by defective sanitary conditions, added but little or nothing to the force or vii'ulcnce of such contagion. To attempt an enumeration of the A-arious Avays by Avhich this disease is supj)osed to be disseminated amongst the population, Avould occupy a very considerable amount of time and .space; it may hoAvever suffice to say, that the only knoAvn and reliable method for checking its in'ogress is to isolate all avIio are attacked by it, until such time as the infection has entirely ceased, and thoroughly to disinfect clothing, bedding, and every article of furniture contained in the sick room. Convinced that the only means which 1 had the jJOAver to emjjloy for staying its raviiges in this Parish AViis by the free and judicious use of disinfectants, I ajAplied for, and readily obtained from the Vestry, authority to adopt such measures of disinfection as in my judgment I thought necessaj’y. I therefore lost no time in procuring an abundant su]>ply of Carbolic Acid, Carbolate of Lime, Chloride of Lime, Chlorate of Potash, Hydrochloric Acid, Suljffiur, and Condy’s Fluid, and having especially appointed Mr. Lightfoot, one of the Inspectors, to carry out my in.structions, Ave at once commenced by systematically disinfecting every house in the Parish in Avhich Fever or Scarlet Fever had been reported to me as having broken out. The method of disinfection Avas as follcAvs :—Every room in Avhich a person had died from Scarlet or Typhoid Fev?i', or from which a person had been removed suffering from cither of the,sc](https://iiif.wellcomecollection.org/image/b22412311_0004.jp2/full/800%2C/0/default.jpg)